社区获得性肺炎患儿血清25羟维生素D与炎性因子、免疫指标的相关性研究  

Correlation between serum 25-hydroxyvitamin D and inflammatory cytokines as well as immune indexes in children with community-acquired pneumonia

作　　者：代宝春 景素敬 王雅坤[1] 赵丽平 张娟[1] 姜红[1] 刘秀珍[1] DAI Baochun;JING Sujing;WANG Yakun(Handan Central Hospital,Hebei,Handan 056008,China;不详)

机构地区：[1]河北省邯郸市中心医院,056008 [2]河北省邯郸市第二医院

出　　处：《河北医药》2022年第1期90-92,96,共4页Hebei Medical Journal

基　　金：河北省医学科学研究重点课题计划(编号:20191853)。

摘　　要：目的探讨社区获得性肺炎(CAP)患儿血清25羟维生素D[25(OH)D]与炎性因子、免疫指标的相关性。方法选取2019年10月至2020年10月收治的CAP患儿98例,根据病情严重程度分为轻症CAP组(n=40)和重症CAP组(n=58)。另选取同期于儿科体检的80例健康儿童作为对照组。比较3组血清25(OH)D、炎性因子[白介素6(IL-6)、C-反应蛋白(CRP)、降钙素原(PCT)]、T淋巴细胞亚群(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、NK细胞、免疫球蛋白(IgG、IgA、IgM)水平及症状体征消退时间、住院时间。结果轻症CAP组、重症CAP组血清25(OH)D缺乏或不足比率、IL-6、CRP、PCT、CD_(8)^(+)水平显著高于对照组,25(OH)D、CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、NK、IgG、IgA、IgM水平显著低于对照组,差异均有统计学意义(P<0.05);重症CAP组血清25(OH)D缺乏或不足比率、IL-6、CRP、PCT、CD_(8)^(+)水平显著高于轻症CAP组,25(OH)D、CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、NK、IgG、IgA、IgM水平显著低于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,血清25(OH)D水平与CD_(3)^(+)、CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)、NK、IgG、IgA、IgM水平呈正相关(r值分别为0.545、0.513、0.498、0.511、0.567、0.501、0.537,P<0.05),与IL-6、CRP、PCT、CD_(8)^(+)水平、症状体征消退时间、住院时间呈负相关(r值分别为-0.576、-0.505、-0.529、-0.556、-0.541、-0.532,P<0.05)。结论CAP患儿普遍存在维生素D缺乏或不足,且维生素D水平与疾病严重程度、炎性因子和免疫指标密切相关。Objective To investigate the correlation between serum 25-hydroxyvitamin D and inflammatory cytokines as well as immune indexes in children with community-acquired pneumonia(CAP).Methods A total of 98 children with CAP who were treated in our hospital from October 2019 to October 2020 were enrolled in the study.According to the severity of the disease,the patients were divided into mild case group(n=40)and severe case group(n=58),at the same time,the other 80 healthy children who underwent physical examination were enrolled as control group.The serum levels of 25(OH)D,inflammatory cytokines[interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT)],T lymphocyte subsets(CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+)),NK cells,immunoglobulin(IgG,IgA,IgM),and the regression time of symptoms and signs,and length of hospital stay were observed and compared among the three groups.Results The proprtion of serum 25(OH)D deficiency or insufficiency,and the levels of IL-6,CRP,PCT,CD_(8)^(+) in mild case group and severe case group were significantly higher than those in control group,however,the levels of 25(OH)D,CD_(3)^(+),CD_(4)^(+),CD_(8)^(+),CD_(4)^(+)/CD_(8)^(+),NK,IgG,IgA,and IgM levels were significantly lower than those in control group(P<0.05).The serum 25(OH)D deficiency or insufficiency ratio,and the serum levels of IL-6,CRP,PCT,CD_(8)^(+) in severe case group were significantly higher than those in mild case group,whereas the levels of 25(OH)D,CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+),NK,IgG,IgA,and IgM were significantly lower than those in control group(P<0.05).Pearson correlation analysis showed that serum 25(OH)D levels were positively correlated with those of CD_(3)^(+),CD_(4)^(+),CD_(4)^(+)/CD_(8)^(+),NK,IgG,IgA,and IgM(P<0.05),however,which were negatively correlated with those of IL-6,CRP,PCT,CD_(8)^(+),and the regression time of symptoms and signs as well as the length of hospital stay(P<0.05).Conclusion The vitamin D deficiency or insufficiency exists generally in

关 键 词：社区获得性肺炎 25羟维生素D 炎性因子 免疫指标 

分 类 号：R563.1[医药卫生—呼吸系统]